The world’s largest research hospital is known by a sterile name, Building 10, that doesn’t even begin to explain how lives are changed inside its walls. That’s because the facility at the National Institutes of Health is not just where clinical trials take place, it’s where they begin: with one person willing to let the NIH’s doctors experiment on them.
Those people—the doctors, nurses, and researchers; the patients and their families—are the subjects of Discovery Channel’s First in Human, a three-episode, six-hour series that airs Thursdays at 9 for the next three weeks.
The series opens with a familiar person: actor Jim Parsons, from The Big Bang Theory and Hidden Figures. Once you get past the celebrity and Parsons’ sometimes-infantilizing narration and the introductions to the patients and their doctors, the show just takes us into their lives at the NIH, and there’s not just emotional death, but life-or-death tension. I started off annoyed and by midway through episode one, I was crying.
It’s thoroughly captivating television, and also a privilege to be allowed to see what what happens as patients receive treatment, and their diseases and bodies and their doctors respond.
The series is a passion project for its director, John Hoffman, Discovery’s executive vice president of documentaries and specials, who came in to help turn the network away from fiction masquerading as fact. I talked to him about the show, which he brought with him when he joined Discovery two years ago.
First in Human is the result, Hoffman said, of “a long process working very, very collaboratively with the entire staff of Building 10 at the NIH.”
Why patients at a hospital agreed to be filmed
Six hours of television come from one year’s worth of filming, from the summer of 2015 to the summer of 2016, when three crews spent 50 to 60 hours every week. While they took weekends and breaks, “everyone was on call at all times,” Hoffman said,” so “if anything was happening with any of our characters either their doctor was making us aware of or the nurse was making us aware of.”
Every person who appears on camera, from doctors to patients to family, consented to be filmed—a process that’s complicated because producers can’t just contact patients directly. Instead, the communications department at the hospital and the nursing staff made the initial contact.
Hoffman told me they’d say something like, “You’re coming in, Discovery is doing a documentary, they’re here for a year. Would you be willing to learn more about it? And that would start the process.”
Most people said yes.
“It’s not hard to get people,” Hoffman said. “They understand implicitly that they are making a contribution, and if they can help one other person who’s in their condition, then they feel that their struggles mean something. They matter.”
Spending so much time with patients meant that “we became part of their lives,” Hoffman told me. The camera operator and sound person become “part of the family. If [the crew] are not in the room, not following, then something’s changed.”
The science of treatment—and narration
First in Human stays grounded in people, doctors and their patients, and thus doesn’t dive too deeply into science or the politics of medicine, a choice that frustrated me as a viewer initially. “It’s a light touch overall when it comes to some of those issues,” Hoffman said.
The same is true for the science. “There’s not a lot of science that’s presented. It’s something that in certain points in the edit room, you’re realizing you just can’t ask people to take in that much science,” he said. “You have to really give them just as much as they need to understand.”
Helping them to understand required a narrator. While Hoffman and the film’s editors tried without a narrator—which he said is “usually the default” because that means “you’re really letting people think for themselves and draw their own conclusions”—that approach did not work for First in Human.
“It became clear halfway through the editing that you really needed the efficiency of a narrator to contextualize what’s happening in these people’s lives,” he said. “We were spending too much time on getting many different characters to do the expository parts.”
Jim Parsons was chosen as narrator. “It was [Discovery president] Rich Ross’ decision [and] idea to go after Jim, and the response was immediate interest,” Hoffman said, snapping his fingers to indicate how fast Parsons said yes. “He fell hard for this project, and I think that the amount of attention that he’s going to bring is invaluable. The celebrity, and there’s an authenticity to him that’s unmistakable.”
The celebrity is “invaluable” because it’s hard to maintain ratings for this kind of show. “To get people back [to watch] week after week is hard,” Hoffman said, adding that multi-episodic documentary series like this one will be “a little bit of an outlier” for Discovery, and most of Discovery Imprint’s documentaries will be one-offs—”the vast majority.”
The NIH is ‘government at its best’
Hoffman got the idea for First in Human while filming other documentaries over the years at NIH, such as HBO’s The Weight of the Nation.
“I would get chills when I walked into Building 10. It’s a beautiful building, it’s an enormous building,” he said, and he knew he wanted to make a film about it “when I learned that the only thing that happens here are clinical trials, everybody who walks through those doors is being treated for free.”
“I didn’t understand that this existed. So after 12 years with the NIH, partnering with them, I had the courage to step forward and say, I’d like to tell the story of what goes on here. No one had ever been granted access,” Hoffman said.
“I’m very proud of having their trust to tell that story, and to make the American public aware that this is our government at its best. We set the bar, and no one has matched this—there’s no government anywhere else in the world that invests more than we do in basic medical research.”
Still, that funding is under threat: Donald Trump proposed cutting the NIH’s budget by $1.2 billion. Instead, Republicans and Democrats worked together and increased its budget by $2 billion, though another budget fight is coming this fall.
“A great motivation for doing this was to do whatever I can to protect that investment that this country makes in basic medical research,” Hoffman told me. “The people who say that times are tough, we have to cut back on basic medical research—any of them who has a child that gets sick, they’re going to want every discovery possible that’s going to save their child’s life. That’s the kind of society we are, and we have to protect that.”